Relation between vitamin D and COVID-19 in Egyptian patients
Nour Hussein Hammam, Mona Ramadan Abdel Aziz, Alshaimaa Mohamed Mosaad Soliman, Sarah Younes Abdel Aziz, Eman Hussein Soliman Altaweel, Asmaa M A Omran, Mervat Ragab Abdel Rahman Nassar
The Egyptian Journal of Internal Medicine, doi:10.1186/s43162-024-00351-3
Background Insufficient vitamin D (VD) levels have been linked to a higher vulnerability to acute respiratory infections and the severity of COVID-19 sickness. Objective The purpose of this research is to investigate whether or not there is a connection between the amounts of VD produced by patients from Egypt and the severity of COVID-19, as well as the consequences of the disease.
Methods This research used a case-control design and included a total of 90 adult patients who had been diagnosed with COVID-19, as well as 90 healthy controls who were matched in terms of age and sex. Patients were classified into mild, moderate, and severe categories according to clinical and radiological criteria. The study included measuring levels of VD and analyzing their relationships with illness severity, inflammatory markers, radiological findings, and outcomes. Results COVID-19 patient(s) had notably reduced levels of serum VD versus the control group (11.78 ± 3.24 ng/ mL vs. 20.88 ± 7.76 ng/mL, p < 0.001). Lower VD levels were associated with more severe disease (p < 0.001), dyspnea (p < 0.001), radiological abnormalities (p = 0.001), and higher mortality (p < 0.001). A serum VD level ≤ 14.8 ng/mL could differentiate COVID-19 patients from controls with 86.67% sensitivity and 77.78% specificity (AUC = 0.881). Conclusions COVID-19 patients often had a deficiency of VD, which was linked to more severe illness, respiratory issues, aberrant radiological findings, and higher fatality rates. VD levels may be used as a biological surrogate marker to assess the risk and predict the outcome of COVID-19.
Declarations Competing interests The authors declare no competing interests.
Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
Abrishami, Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study, Eur J Nutr
Ali, Role of vitamin D in preventing of COVID-19 infection, progression and severity, J Infect Public Health
Almehmadi, Association of vitamin D deficiency with clinical presentation of COVID-19, Eur J Inflamm
Ao, Kikuta, Ishii, The effects of vitamin D on immune system and inflammatory diseases, Biomolecules
Avolio, 25-Hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS-CoV-2, Nutrients
Bae, Association of vitamin D status with COVID-19 and its severity: vitamin D and COVID-19: a narrative review, Rev Endocr Metab Disord
Demir, Demir, Aygun, Vitamin D deficiency is associated with COVID-19 positivity and severity of the disease, J Med Virol
Ferder, The world pandemic of vitamin D deficiency could possibly be explained by cellular inflammatory response activity induced by the renin-angiotensin system, Am J Physiol Cell Physiol
Fj, Potential immunomodulatory effects of vitamin D in the prevention of severe coronavirus disease 2019: an ally for Latin America, Int J Mol Med
Gulcan, Is there a relationship between vitamin D levels, inflammatory parameters, and clinical severity of COVID-19 infection?, Bratisl Med J
Hernández, Vitamin D status in hospitalized patients with SARS-CoV-2 infection, J Clin Endocrinol Metab
Huțanu, Low serum vitamin D in COVID-19 patients is not related to inflammatory markers and patients' outcomes-a single-center experience and a brief review of the literature, Nutrients
Ilie, Stefanescu, Smith, The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality, Aging Clin Exp Res
Meltzer, Association of vitamin D status and other clinical characteristics with COVID-19 test results, JAMA Netw Open
Mostafa, Clinical and prognostic significance of baseline serum vitamin d levels in hospitalized Egyptian COVID-19 patients, Int J Gen Med
Rosen, Abrams, Aloia, IOM committee members respond to Endocrine Society vitamin D guidelines, J Clin Endocrinol Metab
Teama, Vitamin D deficiency as a predictor of severity in patients with COVID-19 infection, Sci Prog
Weir, Does vitamin D deficiency increase the severity of COVID-19?, Clin Med (Lond)
Yang, Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis, Int J Infect Dis
Yosef, Vitamin D assessment in patients with COVID-19 virus and correlation with severity, Egypt J Int Med
Yousefzadeh, Shapses, Wang, Vitamin D binding protein impact on 25-hydroxyvitamin D levels under different physiologic and pathologic conditions, Int J Endocrinol
Yılmaz, Şen, Is vitamin D deficiency a risk factor for COVID-19 in children?, Pediatr Pulmonol
DOI record:
{
"DOI": "10.1186/s43162-024-00351-3",
"ISSN": [
"2090-9098"
],
"URL": "http://dx.doi.org/10.1186/s43162-024-00351-3",
"abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>Insufficient vitamin D (VD) levels have been linked to a higher vulnerability to acute respiratory infections and the severity of COVID-19 sickness.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Objective</jats:title>\n <jats:p>The purpose of this research is to investigate whether or not there is a connection between the amounts of VD produced by patients from Egypt and the severity of COVID-19, as well as the consequences of the disease.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>This research used a case–control design and included a total of 90 adult patients who had been diagnosed with COVID-19, as well as 90 healthy controls who were matched in terms of age and sex. Patients were classified into mild, moderate, and severe categories according to clinical and radiological criteria. The study included measuring levels of VD and analyzing their relationships with illness severity, inflammatory markers, radiological findings, and outcomes.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>COVID-19 patient(s) had notably reduced levels of serum VD versus the control group (11.78 ± 3.24 ng/mL vs. 20.88 ± 7.76 ng/mL, <jats:italic>p</jats:italic> < 0.001). Lower VD levels were associated with more severe disease (<jats:italic>p</jats:italic> < 0.001), dyspnea (<jats:italic>p</jats:italic> < 0.001), radiological abnormalities (<jats:italic>p</jats:italic> = 0.001), and higher mortality (<jats:italic>p</jats:italic> < 0.001). A serum VD level ≤ 14.8 ng/mL could differentiate COVID-19 patients from controls with 86.67% sensitivity and 77.78% specificity (AUC = 0.881).</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusions</jats:title>\n <jats:p>COVID-19 patients often had a deficiency of VD, which was linked to more severe illness, respiratory issues, aberrant radiological findings, and higher fatality rates. VD levels may be used as a biological surrogate marker to assess the risk and predict the outcome of COVID-19.</jats:p>\n </jats:sec>",
"alternative-id": [
"351"
],
"article-number": "84",
"assertion": [
{
"group": {
"label": "Article History",
"name": "ArticleHistory"
},
"label": "Received",
"name": "received",
"order": 1,
"value": "28 May 2024"
},
{
"group": {
"label": "Article History",
"name": "ArticleHistory"
},
"label": "Accepted",
"name": "accepted",
"order": 2,
"value": "6 August 2024"
},
{
"group": {
"label": "Article History",
"name": "ArticleHistory"
},
"label": "First Online",
"name": "first_online",
"order": 3,
"value": "16 August 2024"
},
{
"group": {
"label": "Declarations",
"name": "EthicsHeading"
},
"name": "Ethics",
"order": 1
},
{
"group": {
"label": "Competing interests",
"name": "EthicsHeading"
},
"name": "Ethics",
"order": 2,
"value": "The authors declare no competing interests."
}
],
"author": [
{
"affiliation": [],
"family": "Hammam",
"given": "Nour Hussein",
"sequence": "first"
},
{
"affiliation": [],
"family": "Aziz",
"given": "Mona Ramadan Abdel",
"sequence": "additional"
},
{
"ORCID": "http://orcid.org/0000-0002-4753-9826",
"affiliation": [],
"authenticated-orcid": false,
"family": "Soliman",
"given": "Alshaimaa Mohamed Mosaad",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Aziz",
"given": "Sarah Younes Abdel",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Altaweel",
"given": "Eman Hussein Soliman",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Omran",
"given": "Asmaa M. A.",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Nassar",
"given": "Mervat Ragab Abdel Rahman",
"sequence": "additional"
}
],
"container-title": "The Egyptian Journal of Internal Medicine",
"container-title-short": "Egypt J Intern Med",
"content-domain": {
"crossmark-restriction": false,
"domain": [
"link.springer.com"
]
},
"created": {
"date-parts": [
[
2024,
8,
16
]
],
"date-time": "2024-08-16T06:01:57Z",
"timestamp": 1723788117000
},
"deposited": {
"date-parts": [
[
2024,
8,
16
]
],
"date-time": "2024-08-16T06:02:11Z",
"timestamp": 1723788131000
},
"indexed": {
"date-parts": [
[
2024,
8,
17
]
],
"date-time": "2024-08-17T00:23:33Z",
"timestamp": 1723854213506
},
"is-referenced-by-count": 0,
"issue": "1",
"issued": {
"date-parts": [
[
2024,
8,
16
]
]
},
"journal-issue": {
"issue": "1",
"published-online": {
"date-parts": [
[
2024,
12
]
]
}
},
"language": "en",
"license": [
{
"URL": "https://creativecommons.org/licenses/by/4.0",
"content-version": "tdm",
"delay-in-days": 0,
"start": {
"date-parts": [
[
2024,
8,
16
]
],
"date-time": "2024-08-16T00:00:00Z",
"timestamp": 1723766400000
}
},
{
"URL": "https://creativecommons.org/licenses/by/4.0",
"content-version": "vor",
"delay-in-days": 0,
"start": {
"date-parts": [
[
2024,
8,
16
]
],
"date-time": "2024-08-16T00:00:00Z",
"timestamp": 1723766400000
}
}
],
"link": [
{
"URL": "https://link.springer.com/content/pdf/10.1186/s43162-024-00351-3.pdf",
"content-type": "application/pdf",
"content-version": "vor",
"intended-application": "text-mining"
},
{
"URL": "https://link.springer.com/article/10.1186/s43162-024-00351-3/fulltext.html",
"content-type": "text/html",
"content-version": "vor",
"intended-application": "text-mining"
},
{
"URL": "https://link.springer.com/content/pdf/10.1186/s43162-024-00351-3.pdf",
"content-type": "application/pdf",
"content-version": "vor",
"intended-application": "similarity-checking"
}
],
"member": "297",
"original-title": [],
"prefix": "10.1186",
"published": {
"date-parts": [
[
2024,
8,
16
]
]
},
"published-online": {
"date-parts": [
[
2024,
8,
16
]
]
},
"publisher": "Springer Science and Business Media LLC",
"reference": [
{
"DOI": "10.1016/j.ijid.2020.03.017",
"author": "J Yang",
"doi-asserted-by": "publisher",
"first-page": "91",
"journal-title": "Int J Infect Dis",
"key": "351_CR1",
"unstructured": "Yang J et al (2020) Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 94:91–95",
"volume": "94",
"year": "2020"
},
{
"DOI": "10.1210/clinem/dgaa733",
"author": "JL Hernández",
"doi-asserted-by": "publisher",
"first-page": "e1343",
"issue": "3",
"journal-title": "J Clin Endocrinol Metab",
"key": "351_CR2",
"unstructured": "Hernández JL et al (2021) Vitamin D status in hospitalized patients with SARS-CoV-2 infection. J Clin Endocrinol Metab 106(3):e1343–e1353",
"volume": "106",
"year": "2021"
},
{
"DOI": "10.1007/s11154-021-09705-6",
"author": "JH Bae",
"doi-asserted-by": "publisher",
"first-page": "579",
"issue": "3",
"journal-title": "Rev Endocr Metab Disord",
"key": "351_CR3",
"unstructured": "Bae JH et al (2022) Association of vitamin D status with COVID-19 and its severity: vitamin D and COVID-19: a narrative review. Rev Endocr Metab Disord 23(3):579–599",
"volume": "23",
"year": "2022"
},
{
"DOI": "10.7861/clinmed.2020-0301",
"author": "EK Weir",
"doi-asserted-by": "publisher",
"first-page": "e107",
"issue": "4",
"journal-title": "Clin Med (Lond)",
"key": "351_CR4",
"unstructured": "Weir EK et al (2020) Does vitamin D deficiency increase the severity of COVID-19? Clin Med (Lond) 20(4):e107–e108",
"volume": "20",
"year": "2020"
},
{
"DOI": "10.1210/jc.2011-2218",
"author": "CJ Rosen",
"doi-asserted-by": "publisher",
"first-page": "1146",
"journal-title": "J Clin Endocrinol Metab",
"key": "351_CR5",
"unstructured": "Rosen CJ, Abrams SA, Aloia JF et al (2012) IOM committee members respond to Endocrine Society vitamin D guidelines. J Clin Endocrinol Metab 97:1146–1152",
"volume": "97",
"year": "2012"
},
{
"DOI": "10.3390/nu12051359",
"author": "A D’Avolio",
"doi-asserted-by": "publisher",
"first-page": "1359",
"issue": "5",
"journal-title": "Nutrients",
"key": "351_CR6",
"unstructured": "D’Avolio A et al (2020) 25-Hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS-CoV-2. Nutrients 12(5):1359",
"volume": "12",
"year": "2020"
},
{
"DOI": "10.1001/jamanetworkopen.2020.19722",
"author": "DO Meltzer",
"doi-asserted-by": "publisher",
"first-page": "e2019722",
"issue": "9",
"journal-title": "JAMA Netw Open",
"key": "351_CR7",
"unstructured": "Meltzer DO et al (2020) Association of vitamin D status and other clinical characteristics with COVID-19 test results. JAMA Netw Open 3(9):e2019722–e2019722",
"volume": "3",
"year": "2020"
},
{
"DOI": "10.1016/j.jiph.2020.06.021",
"author": "N Ali",
"doi-asserted-by": "publisher",
"first-page": "1373",
"issue": "10",
"journal-title": "J Infect Public Health",
"key": "351_CR8",
"unstructured": "Ali N (2020) Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health 13(10):1373–1380",
"volume": "13",
"year": "2020"
},
{
"DOI": "10.1152/ajpcell.00403.2011",
"author": "M Ferder",
"doi-asserted-by": "publisher",
"first-page": "C1027",
"issue": "11",
"journal-title": "Am J Physiol Cell Physiol",
"key": "351_CR9",
"unstructured": "Ferder M et al (2013) The world pandemic of vitamin D deficiency could possibly be explained by cellular inflammatory response activity induced by the renin-angiotensin system. Am J Physiol Cell Physiol 304(11):C1027–C1039",
"volume": "304",
"year": "2013"
},
{
"DOI": "10.3892/ijmm.2021.4865",
"author": "FJ TurrubIATes-HernánDez",
"doi-asserted-by": "publisher",
"first-page": "1",
"issue": "4",
"journal-title": "Int J Mol Med",
"key": "351_CR10",
"unstructured": "TurrubIATes-HernánDez FJ et al (2021) Potential immunomodulatory effects of vitamin D in the prevention of severe coronavirus disease 2019: an ally for Latin America. Int J Mol Med 47(4):1–1",
"volume": "47",
"year": "2021"
},
{
"DOI": "10.3390/biom11111624",
"author": "T Ao",
"doi-asserted-by": "publisher",
"first-page": "1624",
"issue": "11",
"journal-title": "Biomolecules",
"key": "351_CR11",
"unstructured": "Ao T, Kikuta J, Ishii M (2021) The effects of vitamin D on immune system and inflammatory diseases. Biomolecules 11(11):1624",
"volume": "11",
"year": "2021"
},
{
"DOI": "10.1002/jmv.26832",
"author": "M Demir",
"doi-asserted-by": "publisher",
"first-page": "2992",
"issue": "5",
"journal-title": "J Med Virol",
"key": "351_CR12",
"unstructured": "Demir M, Demir F, Aygun H (2021) Vitamin D deficiency is associated with COVID-19 positivity and severity of the disease. J Med Virol 93(5):2992–2999",
"volume": "93",
"year": "2021"
},
{
"DOI": "10.1007/s00394-020-02411-0",
"author": "A Abrishami",
"doi-asserted-by": "publisher",
"first-page": "2249",
"journal-title": "Eur J Nutr",
"key": "351_CR13",
"unstructured": "Abrishami A et al (2021) Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study. Eur J Nutr 60:2249–2257",
"volume": "60",
"year": "2021"
},
{
"DOI": "10.2147/IJGM.S386815",
"author": "S Mostafa",
"doi-asserted-by": "publisher",
"first-page": "8063",
"journal-title": "Int J Gen Med",
"key": "351_CR14",
"unstructured": "Mostafa S et al (2022) Clinical and prognostic significance of baseline serum vitamin d levels in hospitalized Egyptian COVID-19 patients. Int J Gen Med 15:8063",
"volume": "15",
"year": "2022"
},
{
"DOI": "10.1007/s40520-020-01570-8",
"author": "PC Ilie",
"doi-asserted-by": "publisher",
"first-page": "1195",
"issue": "7",
"journal-title": "Aging Clin Exp Res",
"key": "351_CR15",
"unstructured": "Ilie PC, Stefanescu S, Smith L (2020) The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res 32(7):1195–1198",
"volume": "32",
"year": "2020"
},
{
"DOI": "10.1002/ppul.25106",
"author": "K Yılmaz",
"doi-asserted-by": "publisher",
"first-page": "3595",
"issue": "12",
"journal-title": "Pediatr Pulmonol",
"key": "351_CR16",
"unstructured": "Yılmaz K, Şen V (2020) Is vitamin D deficiency a risk factor for COVID-19 in children? Pediatr Pulmonol 55(12):3595–3601",
"volume": "55",
"year": "2020"
},
{
"DOI": "10.4149/BLL_2022_065",
"author": "O Gulcan",
"doi-asserted-by": "publisher",
"first-page": "421",
"issue": "6",
"journal-title": "Bratisl Med J",
"key": "351_CR17",
"unstructured": "Gulcan O et al (2022) Is there a relationship between vitamin D levels, inflammatory parameters, and clinical severity of COVID-19 infection? Bratisl Med J 123(6):421–427",
"volume": "123",
"year": "2022"
},
{
"DOI": "10.1177/20587392211038315",
"author": "M Almehmadi",
"doi-asserted-by": "publisher",
"first-page": "205873922110383",
"journal-title": "Eur J Inflamm",
"key": "351_CR18",
"unstructured": "Almehmadi M et al (2021) Association of vitamin D deficiency with clinical presentation of COVID-19. Eur J Inflamm 19:20587392211038316",
"volume": "19",
"year": "2021"
},
{
"DOI": "10.1155/2014/981581",
"author": "P Yousefzadeh",
"doi-asserted-by": "publisher",
"first-page": "981581",
"journal-title": "Int J Endocrinol",
"key": "351_CR19",
"unstructured": "Yousefzadeh P, Shapses SA, Wang X (2014) Vitamin D binding protein impact on 25-hydroxyvitamin D levels under different physiologic and pathologic conditions. Int J Endocrinol 2014:981581",
"volume": "2014",
"year": "2014"
},
{
"DOI": "10.3390/nu14101998",
"author": "A Huțanu",
"doi-asserted-by": "publisher",
"first-page": "1998",
"issue": "10",
"journal-title": "Nutrients",
"key": "351_CR20",
"unstructured": "Huțanu A et al (2022) Low serum vitamin D in COVID-19 patients is not related to inflammatory markers and patients’ outcomes—a single-center experience and a brief review of the literature. Nutrients 14(10):1998",
"volume": "14",
"year": "2022"
},
{
"DOI": "10.1186/s43162-022-00142-8",
"author": "TM Yosef",
"doi-asserted-by": "publisher",
"first-page": "52",
"issue": "1",
"journal-title": "Egypt J Int Med",
"key": "351_CR21",
"unstructured": "Yosef TM et al (2022) Vitamin D assessment in patients with COVID-19 virus and correlation with severity. Egypt J Int Med 34(1):52",
"volume": "34",
"year": "2022"
},
{
"DOI": "10.1177/00368504211036854",
"author": "MAEM Teama",
"doi-asserted-by": "publisher",
"first-page": "003685042110368",
"issue": "3",
"journal-title": "Sci Prog",
"key": "351_CR22",
"unstructured": "Teama MAEM et al (2021) Vitamin D deficiency as a predictor of severity in patients with COVID-19 infection. Sci Prog 104(3):00368504211036854",
"volume": "104",
"year": "2021"
}
],
"reference-count": 22,
"references-count": 22,
"relation": {},
"resource": {
"primary": {
"URL": "https://ejim.springeropen.com/articles/10.1186/s43162-024-00351-3"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subject": [],
"subtitle": [],
"title": "Relation between vitamin D and COVID-19 in Egyptian patients",
"type": "journal-article",
"update-policy": "http://dx.doi.org/10.1007/springer_crossmark_policy",
"volume": "36"
}
